Why Must Kidney Patients Prioritise Vaccination During Monsoon - Dr Viswanath Billa

Many people with early-stage kidney disease feel perfectly healthy and may question the need for vaccinations. 

However, scientific evidence shows that even mild chronic kidney disease predisposes patients. Vaccination is Essential for People with Kidney Disease This Monsoon

By Dr Viswanath Billa, to an increased risk of infections, virus-associated cancers, and a diminished vaccine response. This becomes particularly concerning during the monsoon season when infection rates soar.

Understanding Your Immune System and Kidney Disease

Your kidneys do more than filter waste - they play a crucial role in maintaining your body's defence system. 

Research demonstrates that cardiovascular disease and infections account for up to 70% of all deaths among patients with chronic kidney dysfunction. Here's what happens to your immunity when your kidneys are affected:

The Science Behind Weakened Immunity:

• CKD patients exhibit decreased levels of naive and regular T cells, as well as naive and memory B cells

• The accumulation of uremic toxins suppresses immune function and increases the risk of infections

• Loss of immune homeostasis in renal disease results in perpetual immune cell recruitment and worsening damage to the kidney

The Monsoon Threat: A Perfect Storm for Infections

During monsoon season, the combination of increased humidity, contaminated water sources, and proliferation of disease-carrying mosquitoes creates ideal conditions for infection spread. 

Studies from major Indian cities show that 13.21% of patients with acute febrile illness during the monsoon developed acute kidney injury.

Common Monsoon Infections That Threaten Kidney Patients:

• Pneumonia and respiratory infections

• Dengue fever

• Malaria

• Leptospirosis

• Gastroenteritis

• Typhoid fever

Prevention is Better Than Cure: The Power of Vaccination

1. Pneumococcal Vaccine: Your Shield Against Deadly Pneumonia

Why It's Critical:

• Pneumococcal pneumonia causes death in 5 to 7 per cent of people who get it

• Pneumococcal conjugate vaccines (PCV) result in a 45% decreased incidence in vaccine-type pneumonia, and a 75% decrease in vaccine-type invasive pneumococcal disease

• PCV13 conferred protection against S. pneumoniae hospitalisation and bacteremia in individuals with reduced kidney function (eGFR 30-59 mL/min/1.73 m²)

Vaccination Schedule: Adults with kidney disease need both PCV13 and PPSV23 vaccines. Most people require:

• First: PCV13 vaccine

• 8 weeks later: PPSV23 vaccine

• 5 years later: Second PPSV23 dose

2. Influenza (Flu) Vaccine: Annual Protection

The Evidence is Clear:

• Among people with CKD, flu vaccination has been associated with reduced hospitalisations

• Significant protective effects were observed for hospitalisation due to influenza or pneumonia (14% reduction) and ICU admission (81% reduction)

• Influenza vaccination can reduce the risk of major adverse cardiovascular events, all-cause mortality, cardiovascular mortality, and myocardial infarction

Important: Get your flu shot by October each year, before the monsoon intensifies.

3. Hepatitis B Vaccine: Long-term Liver Protection

Why Kidney Patients Need It:

• Almost 60% of hepatitis B-infected dialysis patients are at risk of becoming chronic carriers

• Vaccination early in CKD stages has better seroconversion rates than late vaccination

Special Dosing for Kidney Patients:

• Higher doses (40 mcg) compared to standard doses

• 4-dose schedule over 6 months for better protection

• Regular antibody monitoring to ensure continued protection

4. Other Essential Vaccines

• Hepatitis A: Important for preventing liver infections during the monsoon

• Typhoid: Crucial protection against contaminated water/food

• COVID-19: Updated vaccines provide additional protection during respiratory illness season

Practical Monsoon Survival Guide for Kidney Patients

Daily Prevention Strategies

1. Water Safety is Paramount

• Drink only boiled or properly filtered water

• Avoid ice from unknown sources

• Never consume street food or beverages

2. Maintain Strict Hygiene

• Wash hands frequently with soap for at least 20 seconds

• Use alcohol-based sanitiser when soap isn't available

• Change wet clothes immediately to prevent fungal infections

3. Protect Against Mosquitoes

• Use mosquito repellents containing DEET

• Wear long-sleeved clothing during dawn and dusk

• Ensure proper drainage around your home

4. Dietary Precautions

• Eat only freshly cooked, hot food

• Avoid pre-cut fruits and raw vegetables from outside

• Stick to your prescribed kidney-friendly diet

• Say NO to high-sodium monsoon snacks

5. Medication Safety

• Never self-medicate, especially with painkillers

• Common over-the-counter drugs can damage the kidneys further

• Consult your nephrologist before taking any new medication

When to Seek Immediate Medical Help

Contact your doctor immediately if you experience:

• Fever above 100°F (37.8°C)

• Persistent cough or breathing difficulty

• Decreased urine output

• Swelling in feet or face

• Severe fatigue or confusion

• Vomiting or diarrhoea lasting more than 24 hours

The Bottom Line: Your Action Plan

1. Schedule Your Vaccinations NOW: Don't wait for symptoms. Pneumococcal vaccination should be administered to all patients with CKD as early in the disease as possible

2. Complete the Full Course: Partial vaccination provides incomplete protection

3. Monitor Your Health: Keep a daily log of temperature, fluid intake, and any symptoms

4. Stay Connected: Regular follow-ups with your nephrologist are non-negotiable

5. Educate Your Family: They need vaccinations too, to protect you from infections

Remember: Your Kidneys Deserve Extra Care

Having even mild kidney disease doesn't mean living in fear - it means being proactive about your health. With proper vaccination and precautions, you can enjoy the monsoon season while keeping infections at bay.

The evidence is overwhelming: vaccination saves lives, prevents hospitalisations, and helps maintain your quality of life. Don't let preventable infections compromise your kidney health. Talk to your nephrologist today about updating your vaccinations before the monsoon peaks.

Your health is in your hands. Make vaccination your priority - because when it comes to kidney disease, prevention truly is the best cure.

For personalised vaccination schedules and kidney care during the monsoon, consult your nephrologist. This guide provides general information and should not replace professional medical advice.

Disclaimer: The views expressed in this article are of the author and not of Health Dialogues. The Editorial/Content team of Health Dialogues has not contributed to the writing/editing/packaging of this article.